"By and large, even if patients are agitated or concerned, they see a dog and immediately they relax," said Van Raalte, a retired nurse who lives in San Rafael.

For seven years, Van Raalte and April have been relieving anxiety in the waiting room.

"I don't know who appreciates their visits more, the patients or the staff," said chief radiation therapist Alice Dunning.

Dogs are excellent icebreakers, Van Raalte said, giving patients something else to talk about besides their health problems. Everyone either has a dog, has befriended a dog or just wants a moment of unconditional love in a time of need, she said.

Van Raalte doesn't talk about herself with patients, but she understands a bit about what it means to be frightened by cancer. In 2004, she lost her twin sister, an HIV/AIDS nurse at UCSF, to breast cancer. Her sister Gretchen was 61.

"It feels good to spend time with people in similar situations," Van Raalte said. "And sometimes I think April knows. She's so peaceful and gentle, but more so when we are here."

On a recent visit to the waiting room, Van Raalte saw Louise Neustadt waiting quietly in a hospital robe, with her daughter by her side. Neustadt lit up in smiles at the unexpected sight of April.

"Oh, I have a golden Lab!" Neustadt said, reaching out for the dog. April came and sat by her side, to accept scratches and pets. Van Raalte showed Neustadt how to get April to do a high-five for a small sausage treat.

"Dogs are so unconditional with their love. They come right to you; they aren't like people who are uncomfortable and don't know what to say," said Neustadt, who said she is in the middle of her fifth battle with cancer.

Van Raalte said she was tricked into volunteering. She asked her friend Etta Allen, then board director of Guide Dogs for the Blind, to help her adopt a retired guide dog. Allen, who was starting the dog therapy program at Marin General Hospital at the time, made a deal - a dog in exchange for a promise to visit cancer patients once a week. Sometimes Allen shows up in the waiting room with her own black Lab, Beverly.

Van Raalte laughs now at the thought that she needed any coercion to do something that gives her so much joy.

"Cancer is a terrible disease," she said. "I just want to be there to help people. It's as simple as that."